The hospital is the fifth largest employer in the region and announced Monday morning that 300 to 400 positions will be cut from its total staff of 16,000.

The layoffs will happen in two phases, the first starting immediately and the second after the new year.

Orlando Health said the layoffs allow them to become more cost efficient because of the upcoming healthcare mandates.

This fiscal year, the hospital saw a $59 mllion drop in government reimbursements for Medicaid, that is medical care for the poor.

"Healthcare reform mandates and changes in reimbursement structures for Medicare and Medicaid are forcing healthcare organizations throughout the U.S. to confront new challenges," said Sherrie Sitarik, president and CEO of Orlando Health. "We must find better ways to deliver enhanced value to patients and lower the overall cost of care."

Cecil Ashley is an occasional patient at Orlando Regional Medical Center and said he's not sure job cuts are best.

"There are many many ways a hospital can save money, as well as other organizations," said Ashley. "They have just got to have people sit down, and figure out where their problems are."

Dr. Steve Rosenberg is with the Orange County Medical Society and said doctors, like hospitals, are staring a smaller profit margins as the nation covers more medical care for the uninsured.

"Hospitals are businesses like everybody else," said Rosenberg. "You have to basically try to do more with less. So this is one of the problems that they have, compounding that you have new regulations with Obamacare, where they are going to ask hospitals to do more, and with less money."

Last week, Orlando Health announced the purchase of Physician Associates.